This application requests support to establish the Western Mental Health Research Center (WMHRC) as a collaborative effort by the Oregon Health Sciences University (OHSU) Department of Psychiatry, the State of Oregon Mental Health Division, and the Kaiser Permanente Center for Health Research (CHR). The purpose of the WMHRC is to study the delivery of mental health services to severely mentally ill individuals. The WMHRC will provide an environment in which researchers can make use of data provided by Oregon's public and private mental health systems to examine innovative mechanisms for maintaining severely mentally ill persons in the community. Oregon's public mental health system is nationally recognized for its dedication to meeting the needs of the chronically mentally ill. The WMHRC will allow researchers to build on longstanding relationships among the three collaborating institutions in order to study this model system. Clinicians, administrators, and researchers will collaborate in predicting and analyzing the effects of policy changes. Methodology will be developed to evaluate the effectiveness of public mental health programs. Computer linkages will be established among the OHSU Department of Psychiatry, the State of Oregon Mental Health Division, and the CHR. These linkages will facilitate the exchange and analysis of data derived from Oregon's programs for the sverely mentally ill. Interdisciplinary projects will foster a flow of information between clinicians in the public mental health sector and researchers. Two major studies of the right to refuse treatment and of severely mentally ill health maintenance organization members will begin when the WMHRC is funded. Future research at the WMHRC will focus on "hard to place" state hospital patients, chronically mentally ill Indochinese refugees, geriatric state hospital patients, and capitated payment systems for the chronically mentally ill.